Chapter 140. Infections Due to the HACEK Group and Miscellaneous Gram-Negative Bacteria (Part 3)

Other Gram-Negative Bacteria Achromobacter xylosoxidans A. xylosoxidans (previously Alcaligenes xylosoxidans) is probably part of the endogenous intestinal flora and has been isolated from water sources. Immunocompromised hosts, including patients with cancer and post- chemotherapy neutropenia, cirrhosis, and chronic renal failure, are at increased risk. Nosocomial outbreaks of A. xylosoxidans infection have been attributed to contaminated fluids, and clinical illness has been associated with isolates from many sites, including blood (often in the setting of intravascular devices). Community-acquired bacteremia with A. xylosoxidans usually occurs in the setting of pneumonia. Metastatic skin lesions are present in one-fifth of cases. The reported mortality rate is...